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日常活动中的一过性心肌缺血发作,多数不伴有心绞痛症状,称为隐性心肌缺血。其机理是心肌需氧量增加和冠脉血流减少。隐性心肌缺血发作的次数和持续时间,在中午前明显增加,夜间则减少。这种昼夜节律很符合心率、血压、急性心肌梗塞、猝死、血栓性卒中、血小板聚集、血浆儿茶酚胺和皮质醇水平等的变化模式。因而,它与心绞痛的临床意义相同;治疗时应针对缺血发作而不是心绞痛或胸痛症状。硝酸酯硝酸甘油降低前、后负荷和心肌张力,而降低心肌需氧量;扩张大冠脉及其侧支,而增加心肌供氧量。它通过改善局部血流而控制
A transient myocardial ischemic attack in daily activities, most are not associated with angina pectoris symptoms, known as occult myocardial ischemia. The mechanism is increased myocardial oxygen demand and coronary blood flow decreased. The number and duration of occult ischemic attacks increased significantly by noon and decreased at night. This circadian rhythm is consistent with changes in heart rate, blood pressure, acute myocardial infarction, sudden death, thrombotic stroke, platelet aggregation, plasma catecholamines and cortisol levels. Thus, it has the same clinical significance as angina pectoris; the treatment should target ischemic attacks rather than angina or chest pain. Nitroglycerin nitroglycerin to reduce the load before and after the load and myocardial tension, and reduce myocardial oxygen demand; dilatation of the large coronary artery and its collateral, and increase myocardial oxygen supply. It is controlled by improving the local blood flow